Date: 10/21/2018

Web BSR11 Multi-purpose Extension Request Form

 Explanation of extension types

After you enter your contact information once in the relevant fields that follow, you can then submit data to ANSI in one of two ways: 1) by entering required () data for each standard in the fields shown below (i.e., using the Submit Data Form tab); or 2) by downloading and submitting data in an Excel table (i.e., choose instead the Submit Excel Form tab). If you choose the Submit Excel Form tab, specific instructions will display. Otherwise, choose “Submit Data Form” and please enter your data for each standard into the fields provided. Fields marked with () are required. When you have completed entering the information, you may PREVIEW it, butyou must hit the SUBMIT button to transfer the final data to ANSI. If you would like to addanother standard using the Submit Data Form, click the ADD REQUEST button on the confirmation screen. A receipt for each form successfully entered will be emailed to you directlyupon successful submittal. Please retain a copy of that record as evidence of procedural compliance subject to ANSI Audit.


First Name:
Enter the full title of the standard for which the form is submitted. “ANSI” should not be included in this title.
Please indicate the type of extension requested: (Please see explanation of extension types)
Check here if you are submitting this form in order to modify a recently submitted form that has not been published in ANSI Standards Action.
Enter any additional information PSA staff should know about this submittal.
When you have finished entering the information, hit the SUBMIT button to transfer the data to ANSI. Following this submittal, you will see a confirmation screen indicating that the submittal was successful. You will also receive a confirmation email containing a copy of your completed form. Please retain this email for your records. If you do not see the confirmation screen or if you have any questions please contact us at psa@ansi.org.

Excel BSR11 Multi-purpose Extension Request Form


  • Click Download to save the Excel template to your computer.
  • If you have the template, skip the download and go to the next step.
  • Open the file on your computer; enter your data, completing all required columns.
Save the file under a new name in your ANS documentation folder.
  • Note: these files are subject to ANSI audit so please name them for easy identification.



Click Browse to select, upload and attach your file to this web form.
  • Note: the file name should be displayed in the field provided

Click Submit to transmit your attached submittal.
  • A confirmation screen will be displayed when successfully transmitted.
  • A receipt with a copy of your submittal will be emailed to you within a day.
  • Note: retain the copy with your ANSI audit records.

If the file is not displayed or if you do not receive a confirmation, your file has not been transmitted to ANSI. Try Again! For questions or assistance, please contact ANSI staff at psa@ansi.org. We will respond to your inquiry within 24 hours.

This form is submitted to the Procedures and Standards Administration (PSA) Department in accordance with the requirements set-forth in the ANSI Essential Requirements: Due process requirements for American National Standards (ANSI Essential Requirements)